OUT Health and Wellness Transgender 'conversion therapy' associated with 'severe psychological distress'

Transgender 'conversion therapy' associated with 'severe psychological distress'

A study in JAMA Psychiatry is one of the first to highlight the psychological impact of efforts to change a trans person’s gender identity.

A new large-scale study linking conversion therapy - an approach founded on disaffirming a person’s self-identified gender or sexual orientation - is directly link to a sharp increase in suicidal ideation and attempts.

Find more about the benefits of affirmative care, and the risks of disaffirming approaches, at our website:

www.gdaworkinggroup.com

And follow us on Facebook for regular updates:

@gdaffirmative

“Exposure to "conversion therapy" — efforts by a secular or religious professional to change a transgender person’s gender identity — is associated with thoughts of and attempts at suicide, according to a study published Wednesday in the journal JAMA Psychiatry…”

“…But this was novel, he said, because of its large sample size — over 27,000 transgender people responded to the survey — and its broad approach to identifying past efforts to change participants’ gender identity...”

“…Turban said that previous reports showing the negative effects of conversion therapy, also known as “ex-gay therapy” or “reparative therapy,” have focused on efforts to change a person’s sexual orientation…”

“But this was novel, he said, because of its large sample size — over 27,000 transgender people responded to the survey — and its broad approach to identifying past efforts to change participants’ gender identity...”

“"The term 'conversion therapy' is a misnomer,” Keuroghlian noted. “It suggests that conversion efforts are a legitimate therapeutic practice, even though we are finding that this practice is associated with significantly increased risk of harm, including serious psychological distress and potentially fatal suicide attempts.””

https://www.nbcnews.com/feature/nbc-out/transgender-conversion-therapy-associated-severe-psychological-distress-n1052416

Presentation by the WPATH Standards of Care 8 Child Chapter Working Group

On September 7, 2019, members of the Standards of Care Version 8 - Child Chapter Working Group delivered a presentation at the US Professional Association of Transgender Health conference in Washington DC. This presentation outlined a significant move toward far more affirming philosophies of care, which will appear in the upcoming SOC V8.

Find more information on Affirmative Care for transgender and gender noxnbinary youth and adolescents at our website: www.gdaworkinggroup.com

And follow us on Facebook for regular updates: @gdaffirmative

As reported by community rapporteur Lotus Đào, and Dr. Asa Radix, Co-Chair of the SOC8 Review Committee, member of the Board of Directors of the World Professional Association of Transgender Health and the US Professional Association of Transgender Health:

On September 7th, 2019, members of the WPATH Standards of Care 8.0 Child Chapter Working Group presented on "Prepubescent Gender Diversity: Complexities and Recommendations." Presenters opened by sharing the working group's process and naming the complexity of working within a global context in an specialty with few expertise. Following a brief research summary, presenters established a foundation of child gender diversity as an expected aspect of general human diversity, rather than a pathology.

Furthermore, gender identity should not be conflated with gender expression. In fact, research indicates that many young children exhibiting extensive gender expansive behavior while feeling cohesive with their gender identity are likely to evolve to be gay or queer by adolescence, not transgender. In addition, gender identity is sometimes static, and sometimes fluid. Some children know from a very young age who they are and their gender identity is static throughout their lifetime. For other children, their gender identity may change over time. Presenters encouraged providers and community members to practice respect and sensitivity in honoring children where they are at and releasing the cultured need to predict a child's gender identity and presentation. In regards to the mental health provider's role in working with gender expansive children, presenters emphasized that gender expansive children should not be required to be in therapy. However, guidance from mental health providers are often helpful, especially if there are external stressors (family, school, region) or the child is interested in medical treatment.

The presenters provided recommendations for providers around advocacy, including educating and supporting gender diversity is expected and not pathological; acknowledging and addressing privilege and frequent intentional and/or unintentional negating of gender diverse experience; working in partnership with schools and childcare programs to sensitive educational providers to importance of gender affirmative practices to promote curricula; and more.

Presenters shared a much anticipated report of the SOC 8 Core Competency Recommendations, which are not finalized, including compenents on Training/Credentials, Gender Development, Child/Family Mental Health, Assessment, Therapuetic Interventions, Autism and Gender, Research Knowledge and Continuing Education. Ultimately, presenters urged attendees to promote gender literacy with gender expansive children, including identifying oppressive and violent environmental messaging around gender and critically examine whether or not it is authentic. Furthermore, presenters recommended providers to not fixate on pathology or force "transgender" onto gender expansive children, but to incorporate "play" and "fun" as important aspects of working with children.

Scientific American: Stop Using Phony Science to Justify Transphobia

An important overview and piece advocating for inclusivity from the prominent scientific journal Scientific American.

Published: June 13, 2019. Author Simón(e) D Sun.

“While this is a small overview, the science is clear and conclusive: sex is not binary, transgender people are real. It is time that we acknowledge this. Defining a person’s sex identity using decontextualized “facts” is unscientific and dehumanizing. The trans experience provides essential insights into the science of sex and scientifically demonstrates that uncommon and atypical phenomena are vital for a successful living system. Even the scientific endeavor itself is quantifiably better when it is more inclusive and diverse. So, no matter what a pundit, politician or internet troll may say, trans people are an indispensable part of our living reality.”

https://blogs.scientificamerican.com/voices/stop-using-phony-science-to-justify-transphobia/?fbclid=IwAR1ldAXMA8U8YMKN6HJw6eHNqKmpRMXfH8G2cbtkzx6JP4w2iwrV09dDNRs

Counterpoint: Pediatric gender care is safe and necessary

While not research, this is a well written piece, concisely outlining the issues and why evidence-based, affirmative care for trans and gender nonbinary youth is safe and effective, and the current standard of care.

Published in: Star Tribune. June 25, 2019. Authors: KATHLEEN MILLER , MARLA EISENBERG , AMY GOWER AND G. NIC RIDER.

"Transgender and nonbinary youths experience persistent and significant distress when forced to conform to the gender they were assigned at birth. They face substantial health disparities, with higher rates of depression, suicide attempts, substance use, bullying and unprotected sexual encounters than their cisgender (i.e., not transgender) peers. However, research shows that these health outcomes are related to stigma, rather than the simple fact of being transgender or nonbinary. This is a subtle, but critical, distinction: Negative health outcomes are not intrinsic to being trans and nonbinary. Rather, daily experiences of discrimination and harassment lead to poor health outcomes..."

"The medical and research community supports gender affirming medical care as a powerful tool to improve the lives of children and adolescents who are transgender or nonbinary. There is ample and growing evidence that children and adolescents have better health outcomes when they are supported in their gender, which includes access to medical interventions when appropriate. As clinicians and pediatric researchers, we firmly support expanding access to gender affirming care for youth."

http://m.startribune.com/counterpoint-pediatric-gender-care-is-safe-and-necessary/511804792/?fbclid=IwAR0KqZCmu9H8RiUQyTQVVjBDKzlqb5_UjPutRB1CflsVs3AmNhisXrMKG2g

Getting Your Health Care Covered: a Guide for Transgender People

Not research, but a resource that could be quite useful in helping people access care… and we know that the ability to access care has a dramatic and positive effect on outcomes.

"Getting your insurance to cover the health care you need can be difficult. The good news is that it should be getting easier. Many insurance plans have gotten rid of exclusions that single out transgender people, and trans people are protected from public and private insurance discrimination under federal law and state laws, including in Medicaid and Medicare."

"But some insurance plans still make it hard to get coverage for transition-related health care, especially surgical care. "

"The most important thing to remember is that your insurance should cover transition-related care. However, you may need to show your insurance company why the treatment you need is medically necessary for you, with letters from your health care providers."

"If you are denied coverage or if your plan has an exclusion, you may also need to explain to your insurance company or employer why it is illegal discrimination to exclude medically necessary transition-related care."

"Use this guide to help you navigate the coverage process."

https://transequality.org/health-coverage-guide?fbclid=IwAR0AzX8f9kkSsK3ClNYdWBiL204Q5Ladsn-mZgkvgyF-8GLkhsUbJpsObSs

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The Gender Dysphoria Affirmative Working Group would like to thank Saturday Night Live and actor Don Cheadle for their clear and visible statement in support of trans and gender nonbinary youth... some of the most vulnerable in our world today.

Don Cheadle Makes Powerful Fashion Statements On ‘SNL’

The award-winning actor offers support for transgender kids and takes a slap at Donald Trump.

SNL.jpeg

By Carla Baranauckas

“Award-winning actor Don Cheadle had more than laughs on his mind when he hosted “Saturday Night Live” this weekend. And he made that clear with some of his wardrobe choices.”

“When he introduced Gary Clark Jr., the show’s musical guest, Cheadle wore a T-shirt that said, “Protect Trans Kids.” “ 

https://www.huffpost.com/entry/don-cheadle-fashion-statements-snl_n_5c6933e3e4b05c889d20071b?utm_medium=facebook&ncid=fcbklnkushpmg00000063&utm_campaign=hp_fb_pages&utm_source=main_fb&fbclid=IwAR0thfObhPBjBt4cjMummkjmqCDNtncDshtxTDbz7W9q02aCyTwN0goVui8

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

The 2018 Australian SOC for Trans and Gender Diverse Children and Adults... a very strongly affirming document based on the latest research making clear that affirmative treatment approaches - in which the youth's identity is respected and supported, where the youth are provided the freedom and safety to explore their gender without judgment - yield much happier and better adjusted youth and young adults. It also makes clear that disaffirming approaches are unethical and may cause harm.

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

Authors: M.M. Telfer, M.A. Tollit, C.C. Pace, & K.C. Pang.   2018.  

“Being trans or gender diverse is now largely viewed as part of the natural spectrum of human diversity. It is, however, frequently accompanied by significant gender dysphoria (GD), which is characterised by the distress that arises from incongruence between a person’s gender identity and their sex assigned at birth. It is well recognised that trans and gender diverse individuals are at increased risk of harm because of discrimination, social exclusion, bullying, physical assault and even homicide. Serious psychiatric morbidity is seen in children and adolescents. A study of the mental health of trans young people living in Australia found very high rates of ever being diagnosed with depression (74.6%), anxiety (72.2%), post-traumatic stress disorder (25.1%), a personality disorder (20.1%), psychosis (16.2%) or an eating disorder (22.7%). Furthermore 79.7% reported ever self-harming and 48.1% ever attempting suicide.”

 

“Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved.”

 

“Understanding and using a person’s preferred name and pronouns is vital to the provision of affirming and respectful care of trans children and adolescents.  Providing an environment that demonstrates inclusiveness and respect for diversity is essential... Some children or adolescents may request use of a preferred name or pronoun only in certain circumstances, such as when their parents are, or are not, present in the room. This is important to respect and enact to enable optimal patient-clinician engagement, and ensure confidentiality and patient safety.”

 

“Avoiding harm is an important ethical consideration for health professionals when considering different options for medical and surgical intervention. Withholding of gender affirming treatment is not considered a neutral option, and may exacerbate distress in a number of ways including increasing depression, anxiety and suicidality, social withdrawal, as well as possibly increasing chances of young people illegally accessing medications.” 

 

“In the past, psychological practices attempting to change a person’s gender identity to be more aligned with their sex assigned at birth were used.  Such practices, typically known as conversion or reparative therapies, lack efficacy, are considered unethical and may cause lasting damage to a child or adolescent’s social and emotional health and wellbeing.”

 

https://www.rch.org.au/uploadedFiles/Main/Content/adolescent-medicine/australian-standards-of-care-and-treatment-guidelines-for-trans-and-gender-diverse-children-and-adolescents.pdf

 

Young Trans Children Know Who They Are

Young Trans Children Know Who They Are: A new study shows that gender-nonconforming kids who go on to transition already have a strong sense of their true identity—one that differs from their assigned gender.

Published in: The Atlantic. January 15, 2019. Author: Ed Yong

“This study provides further credence to guidance that practitioners and other professionals should affirm—rather than question—a child’s assertion of their gender, particularly for those who more strongly identify with their gender,” says Russell Toomey from the University of Arizona, who studies LGBTQ youth and is himself transgender…”

““When the 85 gender-nonconforming children first enrolled in Olson’s study, her team administered a series of five tests that asked what toys and clothes they preferred; whether they preferred hanging out with girls or boys; how similar they felt to girls or boys; and which genders they felt they currently were or would be. Together, these markers of identity gave the team a way to quantify each kid’s sense of gender.”

“The team, including James Rae, now at the University of Massachusetts Amherst, found that children who showed stronger gender nonconformity at this point were more likely to socially transition. So, for example, assigned boys who had the most extreme feminine identities were most likely to be living as girls two years later. This link couldn’t be explained by other factors, such as how liberal the children’s parents were. Instead, the children’s gender identity predicted their social transitions. “I think this wouldn’t surprise parents of trans kids, and my findings are often ‘duh’ findings for them,” says Olson. “It seems pretty intuitive.””

“…“The findings of this compelling study provide further evidence that decisions to socially transition are driven by a child’s understanding of their own gender,” says Toomey. “This is critically important information given that recent public debates and flawed empirical studies erroneously implicate ‘pushy’ parents, peers, or other sources, like social media, in the rising prevalence of children and adolescents who identify as transgender.””

https://www.theatlantic.com/science/archive/2019/01/young-trans-children-know-who-they-are/580366/

List of professional organisations opposing conversion or reparative therapy targeting transgender and gender non-conforming individuals

Published in: Medium.com. October 4, 2018. Author: Florence Ashley.

“The following list is a compilation of professional organisations which oppose conversion or reparative therapy targeting transgender and gender non-conforming individuals. The list does not include statements which do not clearly and explicitly prohibit practices targeting gender identity. As such, statements which only mention sexual orientation change efforts are not included. “

https://medium.com/@florence.ashley/list-of-professional-organisations-opposing-conversion-or-reparative-therapy-targeting-transgender-f700b4e02c4e

Chosen Name Use Is Linked to Reduced Depressive Symptoms, Suicidal Ideation, and Suicidal Behavior Among Transgender Youth

Even something as “simple” as using a trans youth’s chosen/preferred/self-identified name can be a very powerful intervention with clear positive outcomes. And don’t we want our youth to have less depression, anxiety, and suicidal ideation?

Published in: Journal of Adolescent Health. October, 2018. Authors: Stephen T. Russell, Amanda M. Pollitt, Gu Li, Arnold H. Grossman.

“Transgender youth whose gender expression and names do not appear to match may be vulnerable to unintended disclosure or “outing,” and to discrimination or victimization, factors that could lead to mental health problems [1]. The purpose of the current study was to examine the relation between chosen name use, as a proxy for youths' gender affirmation in various contexts, and mental health among transgender youth.”

“We asked transgender youth whether they had a preferred name different from the name they were given at birth, and, if yes, asked, ‘are you able to go by your preferred name’ at home (n = 54), at school (n = 57), at work (n = 50), or with friends (n=69).”

“…chosen name use in more contexts predicted fewer depressive symptoms and less suicidal ideation and suicidal behavior. An increase by one context in which a chosen name could be used predicted a 5.37-unit decrease in depressive symptoms, a 29% decrease in suicidal ideation, and a 56% decrease in suicidal behavior. We observed similar results when we individually tested specific contexts for chosen name use (except that chosen name use with friends did not significantly predict mental health after adjusting for demographics and close friend support). Depressive symptoms, suicidal ideation, and suicidal behavior were at the lowest levels when chosen names could be used in all four contexts.”

https://www.jahonline.org/article/S1054-139X(18)30085-5/fulltext



Suicide risk in the UK Trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt

Published in: Mental Health Review Journal. · December 2014.  Authors: Louis Bailey, Jay McNeil, Sonja J. Ellis.

“The findings reported here indicate that there are extremely high rates of suicidal ideation and suicide attempt within this non-random sample of the UK trans population. However, gender transition – for those that wanted it – was shown to drastically reduce instances of suicidal ideation and suicide attempt, highlighting the important role played by social transition and gender reassignment in improving quality of life and overall well-being amongst respondents…”

“A key finding to emerge from the study was the importance of timely access to gender reassignment treatment for those who required it. Transition was shown to have a positive impact on trans people’s mental health and well-being; the processes of gender reassignment and social transition serving to significantly reduce rates of suicidal ideation and suicide attempt. The majority of participants cited the significant benefits of gender reassignment in terms of aligning their physical body with their internal sense of self, and the knock-on effects of being recognised as the gender that they felt themselves to be…”

“Despite the clear advantages of gender reassignment, some respondents reported significant issues whilst trying to obtain treatment. As has been reported elsewhere, funding delays or refusals were common within this sample and respondents alluded to having gender reassignment treatment stopped or postponed altogether. These issues may, in some cases, contribute to suicide risk within this population…”

“It is crucial that those experiencing gender dysphoria have access to gender reassignment treatment with minimal delays or disruption and that they receive relevant information and support both from medical professionals as well as more informal sources – such as family, friends and support organisations – in order to build resilience and bolster health and well-being during this particularly difficult time.”

https://www.researchgate.net/publication/281441727

Recognising the needs of gender variant children and their parents

Recognising the needs of gender variant children and their parents

Published in: Sex Education: Sexuality, Society and Learning.  2013.  Authors: Elizabeth A. Riley, Gomathi Sitharthan, Lindy Clemson & Milton Diamond

“The data in the present study suggest that even when gender-variant children actively endeavour to conform, their efforts are often thwarted by individuals who seek to marginalise and victimise them for their difference. Children therefore suffer from an invisibility and lack of recognition of their needs, on the one hand, and (in some cases) a violation of their personal boundaries that can foster a general anxiety, on the other. The well-documented need of all children for acceptance and affirmation places even more responsibility on adults to be compassionate and make provisions for gender-variant children.” 

http://dx.doi.org/10.1080/14681811.2013.796287

The role of gender affirmation in psychological well-being among transgender women

No surprise that validating someone’s sense of self decreases depression and improves self esteem.

Published in: Psychology of Sexual Orientation and Gender Diversity. September 2016. Authors Tiffany R. Glynn, Kristi E. Gamarel, Christopher W. Kahler, Mariko Iwamoto, Don Operario, Tooru Nemoto.

“… we found that social, psychological, and medical gender affirmation were significant predictors of lower depression and higher self-esteem... Findings support the need for accessible and affordable transitioning resources for transgender women in order to promote better quality of life among an already vulnerable population.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5061456/

Suicide risk in the UK trans population and the role of gender transition in decreasing suicidal ideation and suicide attempt

It is well known that trans and gender nonbinary people have high rates of suicidality… studies consistently show that affirming treatments decrease risk.

Published in: Mental Health Review Journal.  December 2014.  Authors: Louis Bailey, Sonja J. Ellis, Jay McNeil.

“A supportive environment for social transition and timely access to gender reassignment, for those who required it, emerged as key protective factors… The paper highlights the devastating impact that delaying or denying gender reassignment treatment can have and urges commissioners and practitioners to prioritisetimely intervention and support.”

“The findings reported here indicate that there are extremely high rates of suicidal ideation and suicide attempt within this non-random sample of the UK trans population. However, gender transition – for those that wanted it – was shown to drastically reduce instances of suicidal ideation and suicide attempt, highlighting the important role played by social transition and gender reassignment in improving quality of life and overall well-being amongst respondents…”

“A key finding to emerge from the study was the importance of timely access to gender reassignment treatment for those who required it. Transition was shown to have a positive impact on trans people’s mental health and well-being; the processes of gender reassignment and social transition serving to significantly reduce rates of suicidal ideation and suicide attempt. The majority of participants cited the significant benefits of gender reassignment in terms of aligning their physical body with their internal sense of self, and the knock-on effects of being recognised as the gender that they felt themselves to be…”

“Despite the clear advantages of gender reassignment, some respondents reported significant issues whilst trying to obtain treatment. As has been reported elsewhere, funding delays or refusals were common within this sample and respondents alluded to having gender reassignment treatment stopped or postponed altogether. These issues may, in some cases, contribute to suicide risk within this population…”

“It is crucial that those experiencing gender dysphoria have access to gender reassignment treatment with minimal delays or disruption and that they receive relevant information and support both from medical professionals as well as more informal sources – such as family, friends and support organisations – in order to build resilience and bolster health and well-being during this particularly difficult time.”

https://www.researchgate.net/publication/281441727_Suicide_risk_in_the_UK_Trans_population_and_the_role_of_gender_transition_in_decreasing_suicidal_ideation_and_suicide_attempt

The Needs of Gender-Variant Children and Their Parents According to Health Professionals

Another article outlining that more supportive, nurturing, and affirming perspectives on a youth’s self-reported gender identity are needed to support both the youth and their parents.

 

Published in: International Journal of Transgenderism.  March 4, 2013.  Authors: Elizabeth Anne Riley, Gomathi Sitharthan, Lindy Clemson & Milton Diamond

“The issues that gender-variant children face highlight consistent deficits and negativity in the children’s lives and focus our attention to the extraordinary burden placed on gender-variant children in their formative years. A report by Grant et al. (2010) describes in detail the extraordinary levels of harassment, physical assault, and sexual violence experienced by transgender children in years during primary and high school. These issues, if unable to be alleviated, are likely to present ongoing and accumulative difficulties that then impact their lives as adults.”

“… The needs of parents overwhelmingly feature the various types of support that would help parents become informed, be able to cope, and make the best decisions for their child. Societal and community support appear to be crucial factors for parents to comfortably engage with the tasks required of them to support their child.”

“… The needs of gender-variant children identified from the professionals’ responses revealed a lack of respect for the rights of children who experience gender variance. The most frequently mentioned needs were to be accepted and supported; to be heard, respected, and loved; to have professional support and recognition; to be allowed to express their gender; to feel safe and protected; to live a normal life; to have peer contact; to have school support and; to have access to puberty-delaying hormones. The needs of the parents focused primarily on areas of support and professional assistance, namely, the need for emotional support and guidance; education and information; support from society, local community, friends, and family; competent knowledgeable professionals; diagnosis, treatment, and beneficial outcomes for their children; peer support; support, understanding, and acceptance from schools; and research.”

“Together, these findings call for education programs to provide knowledge and exposure to the issues that transgender people face, across such sectors as medicine, mental health, and teaching in schools. The targeted education of medical and counseling professionals, the inclusion of printed materials in doctors’ surgeries, and the distribution of best practice guidelines and training in schools would signal a major change across the professional and community sectors that the needs of transgender children are being taken seriously.”

http://www.hawaii.edu/PCSS/biblio/articles/2010to2014/2011-needs-of-gender-variant-children.html

Social Support Networks for LGBT Young Adults: Low Cost Strategies for Positive Adjustment

A study demonstrating that family support is essential in the wellbeing of LGBTQ+ youth.

Published in: Family Relations.  July, 2015.  Authors: Shannon D. Snapp, Ryan J. Watson, Stephen T. Russell, Rafael M. Diaz, Caitlin Ryan.

“Our study adds to the growing body of evidence that family support, both general and sexuality specific, is a crucial factor in LGBT youth’s health and well-being…”

“Two variables were most relevant in predicting adjustment: (a) the percentage of friends who knew about participants’ sexual or gender identity and (b) support related to being LGBT from friends. The presence of a network of friends to whom youth can be out has been linked to measures of health and well-being…”

“Although friendship support is clearly associated with positive well-being in young adulthood, it appears that family acceptance has a stronger overall influence when other forms of support are considered jointly.”

 

https://www.tandfonline.com/doi/full/10.1080/01612840.2017.1398283

Stigma, Mental Health, and Resilience in an Online Sample of the US Transgender Population

Family and peer support, key components of affirmative approaches for gender variant youth, are all protective factors. This study also clearly refutes the notion among some proponents of "Rapid Onset Gender Dysphoria" that disaffirming approaches and limiting access to peers is beneficial. 

Published in: American Journal of Public Health.  May, 2013. Authors: Walter O. Bockting, PhD, Michael H. Miner, PhD, Rebecca E. Swinburne Romine, PhD, Autumn Hamilton, HSD, and Eli Coleman, PhD.

 “… family support, peer support, and identity pride all were negatively associated with psychological distress, confirming that these assets are protective factors. Moreover, peer support significantly moderated the relationship between enacted stigma and psychological distress, thus emerging as a demonstrated factor of resilience in the face of actual experiences of discrimination. Only at high (but not low or medium) levels of peer support was enacted stigma not associated with psychological distress, which suggests that the negative impact of enacted stigma on mental health is pervasive and that regular contact with peers is necessary to ameliorate it.”

“Together, these results offer support for the value of transgender individuals connecting with similar others, possibly providing the opportunity to question stigma from the majority culture and reappraise their experiences in a self-affirmative way, which is consistent with what has been postulated and observed among gay and lesbian individuals. This finding is particularly pertinent because previous research found that transgender people have higher levels of depression and lower levels of peer and family support than their gay, lesbian, and bisexual counterparts. These results support a need to promote resilience by facilitating ample peer support.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3698807/

Surviving a Gender Variant Childhood: The Views of Transgender Adults on the Needs of Gender Variant Children and Their Parents

Published in: Journal of Sex & Marital Therapy. 2012. Authors: Elizabeth Anne Riley, Lindy Clemson, Gomathi Sitharthan, Milton Diamond.

“… the needs of children that emerged were most notably, for parents, school staff and other authority figures to be educated so that children do not need to ‘hide’ themselves and their gender expression for fear of adversity. The participants also expressed their need as children to be able to speak about their feelings, to have their gender expression accepted, to be recognised, to be protected, to be given the opportunity to know others with similar feelings and for their parents to be open-minded, able and willing to accept their gender variant children. This study identified that the participants’ parents primarily needed access to information and educated professionals, particularly in schools, counselling and medical contexts. Exposure to successful transgender people and access to parent support groups was also seen as a need to help parents become more accepting of their children's diversity. The need for family and wider support was mentioned as a need for both the gender variant children and the parents as some participants felt that even though support of their parents was necessary, it was not enough for them to live happily and safely within the broader society.”

“The need for ‘health literacy’ was highlighted as tool to empower individuals, in this case, parents, to respond effectively in addressing the issues with regard to their gender variant children. In particular, allowing confidence to approach professionals for support with their own and their child's emotional, physical and social well-being….”

“… it appears that living in a society where punishment is customary for lack of conformity to gender stereotypes creates a lifelong struggle and sometimes ‘withdrawal’ that caused some participants great distress and impacts on their self-esteem and ability to thrive.”

https://www.semanticscholar.org/paper/Surviving-a-gender-variant-childhood%3A-the-views-of-Riley-Clemson/20d1168cecafe4aa6c633e4691b60e88ed31c901

The Needs of Gender-Variant Children and Their Parents: A Parent Survey

The Needs of Gender-Variant Children and Their Parents: A Parent Survey

Published in: International Journal of Sexual Health. 2011. Authors: Elizabeth Anne Riley, Gomathi Sitharthan, Lindy Clemson, Milton Diamond.

“The results of this study support the development of affirmative approaches in supporting gender-variant children and their parents. This is particularly evidenced by the parents’ own approaches to supporting their children where parents experimented with different ways of responding to various scenarios and realized that acceptance of their child was the only option as they learned that their child’s need for expression was not changed by their attitude or management of the behavior.”

http://www.hawaii.edu/PCSS/biblio/articles/2010to2014/2011-gender-variant-children.html

Mental Health and Self-Worth in Socially Transitioned Transgender Youth

Socially transitioned youth do better than those who do not transition, and do not show higher level of depression or anxiety than their peers or siblings.

Published in the Journal of the American Academy of Child and Adolescent Psychiatry. February 10, 2017. Authors: Lily Durwood, Katie A. McLaughlin, Kristina R. Olson.

“We found remarkably good mental health outcomes in socially transitioned transgender children in the present study. Transgender children reported normative rates of depression and slightly increased rates of anxiety. Rates of depression in transgender children did not differ significantly from those in siblings of transgender children or from those in age- and gender-matched controls, although rates of anxiety were marginally higher. Parents’ reports of their children’s depression and anxiety largely mirrored the children’s reports, although parents of transgender children reported slightly higher anxiety in their children than the children did…”

“Our findings of normative levels of depression, slightly higher rates of anxiety, and high self-worth in socially transitioned transgender children stand in marked contrast with previous work with gender-nonconforming children who had not socially transitioned. Those studies overwhelmingly reported markedly higher rates of anxiety and depression and lower self-worth, with disproportionate numbers of children in the clinical range.”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5302003/